I Think my Breast Implants Ended Up Being Lower Than I Wanted? (photo)

I am 3 months post op. I had 390cc saline moderate profile implants. I went from an A cup to a low C cup. I feel like these are really low and it really bothers me when i look at them. Is this something that is fixable and should I go with a bigger implant to fill out more of the top area?? One side is a little fuller on the top than the other. If I wear a push up bra the each side looks different. One is fuller and has shape and the other side looks deflated. What would my options be?

Doctor Answers 10

Malpositioned Implants - How To Correct Implant Fallout

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Thank you for your challenging questions.  Although you didn't provide us with a pre-operative picture, it is relatively obviously that your right nipple was higher than your left and your left nipple pointed towards your left elbow. 

The right breast needs the bottom lifted.  The lift is best accomplished with one of several techniques for closing off the extra space at the bottom of the breast pocket known as capsulorrhaphies.  Then I would support this new bottom of the implant pocket with Seri (a silk product made by Allergan).  This will insure the bottom of your implant pocket stays where your surgeon puts it. 

As for the left breast, to give the appearance of the left nipple turning in a more anterior direction, I would use a larger high profile implant. When a nipple points significantly to the outside as your left nipple does, it is because it is following the curve of the ribs.  A larger high profile implant should turn that left nipple slightly forward.  This camouflages, to some extent, the malpositioning of your left implant and makes your chest look more symmetrical. 

To gain upper pole fullness, I would change from the moderate implants you presently have to high profile implants.  These will improve the overall appearance of both breasts and give you the fullness you desired. 

I Think my Breast Implants Ended Up Being Lower Than I Wanted?

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         This is absolutely fixable.  The breast pocket can be raised to make the implant appear higher.   Doing this will help with the superior pole fullness though implant size can be increased if desired.  Find a plastic surgeon with ELITE credentials who performs hundreds of breast augmentations and breast augmentation revision procedures each year.  Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.  Kenneth Hughes, MD Los Angeles, CA

Low breast implants can be raised.

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I think your breast implants are too low, specially the right one.  After another two months or so, You can have a revision to raise the folds and make them more symmetrical (capsulorrhaphy).

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

I Think my Breast Implants Ended Up Being Lower Than I Wanted?

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I see two issues: 1. A bottoming out or over directed inferior pocket. 2. Size is to small in my opinion. 

Breast Implant Position After Augmentation

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I agree with your assessment that there is a difference on the two sides and that the right side looks a bit low.  There is something that can be done to correct the low fold on the right side.  It would involve using some of the  capsule that forms around the implant as a sling to hold the implant up.  It is also possible to reset the fold up a little higher.  This would improve the appearance and the symmetry.

Thank you for posting your pictures.  Best of luck to you.   

Al Rosenthal, MD
Lawrenceville Plastic Surgeon

You would probably be happier with a revision

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I agree with you that your implants are positioned too low, and there is also asymmetry between them.  In addition, I do not think you were best served by the use of moderate profile implants as they are somewhat flat and broad on your frame.  I wouldn't necessarily think that increasing the volume of your implants is necessary if all you want is more projection (fullness) as opposed to volume (size), rather, I think you would like the projection that a moderate plus implant provides.  In addition to this, what you will require is a procedure called a "capsulorrhaphy" to tighten the bottom part of the capsule and raise the implants up.  In addition, the surgeon should be sure to evaluate the MEDIAL side (inner side nearest the breastbone) of your RIGHT pocket, as it appears to me that the muscle may have been inadequately released, and this may be causing the position problems with the right implant and the asymmetry that we see.  While some may recommend the use of a "graft" material like Alloderm, Strattice, or Flex HD, at this stage I think it is premature, and a well-performed capsulorrhaphy using your own tissues should suffice.  If it does not, then the graft should be used.  I think that with an increase in the projection of your implants and elevation of them to a more appropriate position, you will have the fullness that you want, and it will be unnecessary to increase the size of the implants.

Joseph L. Grzeskiewicz, MD
San Diego Plastic Surgeon

Concerns about Breast Implant Position after Breast Augmentation?

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I'm sorry to hear about your concerns after breast augmentation surgery. Your concerns are reasonable;  your breast implants do seem to sit relatively low compared to the breast mounds and nipple/areola complexes.

 At some point,  revision breast surgery may be helpful to you.  This operation may involve  "repair" of the inferior breast capsules with permanent internal sutures (capsulorrhaphy). This involves removal of a segment of breast implant capsule among the inferior/lower aspect of the left breast implant pocket. The 2 edges of  capsule tissue are sutured to one another with permanent suture. This procedure reduces the size of the implant pocket and prevents the descent  of the implant on the left side. This procedure will improve the symmetry of the breasts  and the positioning of the nipple–areola on the left breast mound.

 You may find the attached link helpful to you as you learn more about options available.

 Best wishes.

Right implant lower than the left

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I do see asymmetry between your breasts. The right breast appears lower because the right inframammary fold is lower than the fold on the left. As a result, the right implant is sitting lower within its pocket compared to the left. This is the reason why there is less fullness in the upper part of the right breast. The fold on the right can be repaired by capsulorrhaphy to elevate the right breast implant. Thank you for sharing your photos and concerns. Best wishes.

Gregory Park, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 178 reviews

3 Months after Breast Augmentation

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I think I can see why you feel they look different - it looks like your right implant is bottomed out - because it is lower than the fold, lower than the left and your nipple is pointing upward.  This can be fixed but it requires further surgery.  The recovery from this surgery is much easier than your first.  If you wish that you had larger implants, they can be replaced at the same time - otherwise, the revision surgery can be done with your current implants which will save on cost.  Best of luck!  K. Roxanne Grawe, MD Columbus Plastic Surgeon

Think my Breast Implants Ended Up Being Lower Than I Wanted? (p

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Pre op photos would be a help.

It does look like the right side implant has "bottomed out," that is descended lower than the original breast fold. The left breast looks pretty well positioned, and the breast is a bit lower than it might be on some other women, but that is a normal variant of anatomy. 

The right breast can be fixed by reconstructing the breast fold (needs surgery). The breast fold on the left side could also be raised a little at the same time.

Discuss with your surgeon. All the best. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon

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